Why Moving Vaccination Into Pharmacies Is A Win For Everyone

Education and Advocacy Across the entire history of modern medical discoveries, vaccination is among the most important.

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Provided by the Ontario Pharmacists Association

No other medical advancement has contributed so much to the good health of the modern person over the past hundred years. And yet, Canadians are chronically under-immunized, particularly when it comes to adult vaccines.

Vaccines in Canada have traditionally been administered in a doctor’s office by a doctor or nurse, in a process frequently spanning multiple appointments. In many cases, making and keeping those appointments present too much of a barrier to busy Canadians. Pharmacists believe, as the medication experts of our health care system, they could play a role in making vaccination more accessible and efficient. “Pharmacists have a lot of education and training that the current legislation and regulations don’t allow us to actually employ,” says Kingston/Napanee-based pharmacist Jen Baker. “We could prevent a lot of unnecessary doctor visits, and that is time physicians could then spend with another patient with more complex needs. It allows for a more economical and efficient use of our health care assets.”

“Pharmacists have a lot of education and training that the current legislation and regulations don't allow us to actually employ.”

Fortunately, most provinces are now allowing at least some vaccines to be administered directly at the pharmacy. As an example, the flu vaccine was first made available in pharmacies in Ontario in 2012 and, in the 2014–15 flu season, more than 900,000 Ontarians were vaccinated at pharmacies. “Twenty-eight percent of people who got the flu vaccine last year said they wouldn’t have gotten the vaccine if it wasn’t available at their community pharmacy,” reports Baker. A 2012 report by Accenture estimated that the pharmacy-based flu shot program will save the province more than $22 million over the next five years, mainly as a result of avoided flu-related hospitalizations.

Ten provinces with ten different sets of regulations

Despite the successes of flu programs, the national landscape remains a patchwork of inconsistent policies. “On the national level, because health care is a provincial jurisdiction, we are seeing differences in terms of pharmacists’ participation in vaccination,” says Carlo Berardi, Chair of the Canadian Pharmacists Association. “In New Brunswick, for example, pharmacists can not only administer a large number of vaccines — from cholera to hepatitis to shingles to tetanus — they can also assess for and prescribe them. Then you have provinces like Québec, where pharmacists can’t administer any injections.”

On the whole, some provinces have moved to give pharmacists the authority to administer a wide range of vaccines and injectable drugs, while others fall on a spectrum below that ideal. “We would certainly like to see some harmonization and national standards,” says Sean Simpson, Chair of the Board for the Ontario Pharmacists Association. “That’s one of the reasons that, in Ontario, we are really encouraging our government to take a look across the country and catch us up to other provinces.”

Encouragingly, regulatory changes are currently underway in Ontario to enable pharmacists, possibly by the end of the year, to administer travel and other vaccines such as shingles and HPV. With luck, the other provinces and territories that are lagging behind in this area will take note and help Canada realize the goal of comprehensive nationwide pharmacy vaccination. “Pharmacists are ready, willing, and able to do more,” says Simpson. “We just need the shackles to come off.”